Provider Demographics
NPI:1851320048
Name:NEW PATHS TO HEALTHCARE LLC
Entity type:Organization
Organization Name:NEW PATHS TO HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:OBLAS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-C
Authorized Official - Phone:602-405-6320
Mailing Address - Street 1:13838 S 46TH PL
Mailing Address - Street 2:SUITE 340
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-7800
Mailing Address - Country:US
Mailing Address - Phone:602-405-6320
Mailing Address - Fax:480-705-8848
Practice Address - Street 1:13838 S 46TH PL
Practice Address - Street 2:SUITE 340
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-7800
Practice Address - Country:US
Practice Address - Phone:602-405-6320
Practice Address - Fax:480-705-8848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0113363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ114190Medicare PIN